Using simulation and optimization approach to improve outcome through warfarin precision treatment
Using simulation and optimization approach to improve outcome through warfarin precision treatment
复制标题
使用模拟和优化方法通过华法林精准治疗改善结果
DOI：
10.1142/9789813235533_0038
复制
发表时间：
2018
影响因子：
--
通讯作者：
P. Tonellato
中科院分区：
文献类型：
--
作者：
Chih;Lu He;Kourosh Ravvaz;John A. Weissert;P. Tonellato
我们应用治疗模拟和优化方法来制定华法林精确治疗计划的决策支持指南。模拟包括使用由集成的数据驱动和基于领域知识的贝叶斯网络建模方法生成的1，500，000个临床化身（模拟患者）。随后，我们模拟了30天的个体患者对华法林治疗的反应，5个临床和遗传治疗计划，然后进行基于个体和亚群的优化。子群体优化（与个体优化相比）提供了在实际环境中实施精确驱动的治疗计划的成本有效且现实的手段。在这个项目中，我们使用最小熵的属性来最大限度地减少最大可能的患者亚群的总体不良风险，我们通过考虑透明度和易于实施来调整结果。最后，我们讨论了基于子种群优化决策支持规则的精确治疗计划的改进效果。
We apply a treatment simulation and optimization approach to develop decision support guidance for warfarin precision treatment plans. Simulation include the use of ∼1,500,000 clinical avatars (simulated patients) generated by an integrated data-driven and domain-knowledge based Bayesian Network Modeling approach. Subsequently, we simulate 30-day individual patient response to warfarin treatment of five clinical and genetic treatment plans followed by both individual and subpopulation based optimization. Sub-population optimization (compared to individual optimization) provides a cost effective and realistic means of implementation of a precision-driven treatment plan in practical settings. In this project, we use the property of minimal entropy to minimize overall adverse risks for the largest possible patient sub-populations and we temper the results by considering both transparency and ease of implementation. Finally, we discuss the improved outcome of the precision treatment plan based on the sub-population optimized decision support rules.
DOI：
10.1056/nejmoa1310669
发表时间：
2013-12-12
期刊：
The New England journal of medicine
影响因子：
--
作者：
Kimmel SE;French B;Kasner SE;Johnson JA;Anderson JL;Gage BF;Rosenberg YD;Eby CS;Madigan RA;McBane RB;Abdel-Rahman SZ;Stevens SM;Yale S;Mohler ER 3rd;Fang MC;Shah V;Horenstein RB;Limdi NA;Muldowney JA 3rd;Gujral J;Delafontaine P;Desnick RJ;Ortel TL;Billett HH;Pendleton RC;Geller NL;Halperin JL;Goldhaber SZ;Caldwell MD;Califf RM;Ellenberg JH;COAG Investigators
通讯作者：
COAG Investigators
DOI：
10.1056/nejmoa0809329
发表时间：
2009-02-19
期刊：
The New England journal of medicine
影响因子：
--
作者：
International Warfarin Pharmacogenetics Consortium;Klein TE;Altman RB;Eriksson N;Gage BF;Kimmel SE;Lee MT;Limdi NA;Page D;Roden DM;Wagner MJ;Caldwell MD;Johnson JA
通讯作者：
Johnson JA